Stereotype threat is a phenomenon whereby stigmatized individuals face added pressure when they are at risk of confirming negative, group-based stereotypes. It is well-established as a major cause of poor academic performance of Blacks and of women in math. No one has examined whether activation of stereotype threat influences health behavior. For example, stereotype threat might cause a Black man to avoid getting a prostate- specific antigen test in response to a message that "The Black prostate cancer rate is almost twice the rate for other people" with a message that "The prostate cancer rate in Alabama is high" motivating much better. This grant tests the hypothesis that stereotype threat among Blacks also applies to the health domain where it (1) influences reactivity toward and processing of health messaging;(2) reduces capacity to remember health information;(3) decreases persistence toward seeking diagnostic personal health information;and (4) affects decisions about preventive health care. These affects are evaluated experimentally using two-stage experiments. The first stage activates threat among Blacks (but not Whites) in the treatment group by showing Public Service Announcements (PSAs) about health problems that disproportionately affect Blacks. The second stage includes experiments that, for different groups, address selective attention to health information (how hard participants work to watch a blurred health video), persistence in seeking health information (how much of a 717-item health risk appraisal battery they complete when told they are allowed to stop after 36 questions but that their health status will be assessed increasingly accurately as they complete more and more questions), and (through evaluation of the PSAs and a health education program) health information recall and the influence of health information on risk appraisal and resolve to act (e.g., to get hypertension screening or reduce salt intake). The assessment will explore whether post-activation recall differences occur for all messages or just for health messages on stereotypical topics and whether threat invocation affects all recall (and intent to change) or just recall for post-invocation messages. The experiments will support the creation of guidelines for developing stereotype-threat-sensitive health education. A traditional health education program on hypertension will be modified to comply with the guidelines and pilot-tested to show it leads to better knowledge retention and increased resolve to change. Demonstrating that stereotype threat affects health behavior would have important implications for those designing health education and health risk appraisal feedback, as well as helping to differentiate effective from counter-productive approaches to cultural competency. It also would raise a host of follow-up research questions on applicability to other minority groups, mediators and moderators, ways that health-related threat arises, and differential effects of health-related versus more generalized threat conditions (e.g., being the only minority in the room). PUBLIC HEALTH RELEVANCE: This project will determine whether stereotype threat affects the health information processing and health behavior decisions of Blacks. If threat is a problem, the project will develop guidelines for designing health communication and refining cultural competency training and practice that avoid raising stereotype threat.